Provider First Line Business Practice Location Address:
622 W 168TH ST PH 14-104
Provider Second Line Business Practice Location Address:
LUNG TRANSPLANT PROGRAM - NYPH
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-7771
Provider Business Practice Location Address Fax Number:
212-342-2792
Provider Enumeration Date:
04/05/2007